As more and more cases of the omicron variant of covid19 are discovered in the population, the issue of masking and following the other public health regulations is becoming more and more important.
People are being urged to upgrade the quality of their masks, or at the very least, wear them properly.
Speaking at a Ministry of Health media conference on January 15, CMO Dr Roshan Parasram said the omicron variant seems to be more aerosolised (spread through a fine spray) and therefore more transmissible. He said the recommendation is still for surgical masks to be worn, with N95 masks being acceptable.
“We’re looking at a synergistic effect in terms of all the three Ws (wearing a mask, watching your distance and washing your hands) at the same time, so spacing is important to go together with your masking.
"It depends on the type of setting you work in and the individual risk, but from a public-sector-policy perspective we have been saying to wear masks for quite a while, it is now legislation.”
The US Centers for Disease Control (CDC) in January 2020 recommended wearing the most protective mask possible, which should fit well and be comfortable enough to wear consistently.
It said, “Due to the highly transmissible nature of the omicron variant, the CDC recommends wearing NIOSH (National Institute for Occupational Safety) approved respirators. One example is the N95 respirator. However, the CDC recommends reserving this face covering for healthcare settings. Though KN95s do not offer as much protection, they may still be considered. Be sure that your N95 or K95 purchases are not counterfeit.
"The face covering with the best protection is the disposable NIOSH-approved respirator. One example is the N95 respirator which is used for surgery. This face covering leaves no gaps and is built with two straps, not ear loops. The next best alternative is K95 disposable surgical masks which offer a close fit and good protection, though not ranked as high by the CDC as the NIOSH approved respirators. These masks rely on ear loops.”
The CDC said when choosing surgical masks, procedure masks or medical procedure masks, people should look for nose wire, multiple layers of non-woven material, and the ability to fit over the mouth, nose and chin with no gaps.
If cloth masks are being used, it said, tightly woven fabrics and multiple layers are a must.
“For extra protection and better fit, the CDC advises wearing two masks, a cloth mask over a disposable one. You can combine them with a fitter or a brace. If your disposable mask has ear loops, you can create a tighter fit by knotting the ear loops where they join the mask. Elastic straps for the back of the head and neck are more preferable to ear loops, however.”
The World Health Organization (WHO) said on January 5 it recommended three types of masks for the public.
These were:Reusable non-medical masks which comply with the ASTM F3502 standard or CEN Working Agreement 17553, or a non-medical mask meeting WHO essential parameters.
Disposable medical masks which comply with medical mask standards EN 14683 Type I, ASTM F2100 Level 1, YY/T 0969, YY 0469 (or equivalent)
Other types of well-fitting non-medical masks, including homemade multi-layered masks are an acceptable option, when other options are not available.
It said medical/surgical masks are composed of three layers of synthetic non-woven materials, configured to have filtration layers sandwiched in the middle, available in different thicknesses, and have various levels of fluid-resistance and filtration.
Parasram said surgical masks and N95 masks give better protection than cloth and other homemade masks, but getting people to wear masks properly has been difficult.
“It is hard to get people to wear even one mask, to cover your mouth, nose, and chin, right? So if we can have people wearing a mask properly at this point in time, we will take that for now.
"But the guideline, of course, says surgical masks and N95 give you better protection.
"We had done an assessment on cloth masks, through the police service last year, showing good protection. Of course it depends on if you wear one, if you wear two, and the plies...for surgical masks most of them are three-ply, four-ply, which is intrinsic to it, so it depends on the levels of protection, type of material.
“I’m seeing a lot of people wearing surgical masks and then they’re having a cloth mask on top of it, which gives you more protection, so there are variances of all, but we’re really asking everyone to comply with the masking effort.”
Epidemiologist Dr Avery Hinds said, at a Health Ministry conference on January 22, wearing any type of mask properly offers some protection.
“The recommendations on masks and on the different types of masks have always pointed to the fact that there are masks that do more, and masks that do less, but that a mask is better than no mask.
"So whereas the recommendations on reducing risk with omicron suggest that more filtering would be more beneficial, because of the level of transmissibility and the number of particles that are released, we don’t want to take away from the fact that whichever level of masking we adhere to is going to have some effect. So we do want to encourage everyone to wear the masks that they can access and that are accessible and affordable to them.”
He said the N95 and other masks with higher levels of filtration offer greater protection against infection.
“They will do more for you to reduce your risk for inhalation of particles. But at a public health level, we also look at the reduction of your expulsion of droplets, and that is where whichever mask we currently wear will have some effect.
"We do want to continue to encourage everyone to use the masks they have, but be aware of the science that if you want to reduce your own personal risk of inhalation of droplets, especially in enclosed areas and that sort of environment, then yes, the CDC has pointed out that those N95 masks will confer a higher level of benefit.”
Hinds reminded that wearing a mask is important in conjunction with the other two components of the three Ws.
Medical experts said N95 and KN95 masks can be reused once they have been decontaminated. They said in order to decomtaminate, the masks should be placed in brown paper bags which are labelled with the person's name and the date, and stored in a cool dry place for five days.
An article in MedPage Today said using a sealed container or plastic bag is not advised as it would trap moisture and potentially compromise the mask's integrity. It said masks should not be used by more than one person.